- Any causes are hypothetical such as the theory that the inflammation that is caused by the coronavirus causes the digits on the feet to mimic pernio.
- The average length of the condition is seven to ten days.
- If COVID toes occur in these high-risk patients, the likelihood that they will ulcerate is high and will likely require the supervision.
It seems as though the longer the novel coronavirus circulates, the more symptoms arise. Media is consistently updating the nation with the latest developments in the COVID-19 pandemic and this includes the new symptom: COVID toes.
What Are COVID Toes?
The first cases of the purple lesions popping up on the feet (and sometimes hands) of COVID+ patients were announced in a press release from the General Council of Official Colleges of Podiatrists in Spain. They began noticing the purple lesions (predominantly on young people). Some already had other symptoms of COVID-19, but others got sick after the lesions were noted. Even though the lesions can show up on the hands as well, the dermatological community dubbed the lesions “COVID toes.
Are Discolored Toes a Sign that an Otherwise Asymptomatic Patient is COVID+?
It is unclear to physicians if the lesions are appearing strictly before other symptoms set, or if they may be experienced as a lone symptom. One of the initial cases of COVID toes appeared in a 39-year-old male who had no other symptoms than the lesions. The symptom is now being studied closely.
The condition begins with red or purple discoloration. The spots may become raised and some patients have developed ulcerations. They are located on the tips of the digits and pads of the toes and also have been seen on the top of the toes and sides of the feet (as well as a rarity of a case that appears on the hands and fingers). Patients have reported that lesions feel hot and experience a burning and itching sensation.
What is the Cause of COVID Toes?
At this point, more testing is required. Therefore, any causes are hypothetical such as the theory that the inflammation that is caused by the coronavirus causes the digits on the feet to mimic pernio. Pernio is a painful condition that results when the small blood vessels get inflamed from exposure to extreme cold.
Another theory is that the lesions may be occurring as a direct result of clots in the tiny vessels in the feet and toes. This creates a serious issue if the patient already has arterial or venous diseases. If the lesions become ulcerated there will be a need for wound care specialists to be brought in as part of a multidisciplinary team to treat the ulcers.
How Common are COVID Toes Occurring?
Because it is still unclear just how many people have COVID 19, it’s also unclear how many of the COVID+ patients have experienced COVID toes. The American Academy of Dermatology has developed a registry to assess how frequent the symptom is occurring. At the time of this publication, approximately half of the registrants have had COVID toes as a symptom. For younger patients, the only treatment thus far is time. The average length of the condition is seven to ten days.
Covid Toes and the Diabetic and Elderly
Although COVID toes have primarily been reported in younger patients, preparation is needed for the symptom occurring in the elderly and/or immunity compromised patient. This could be an indicator that the infection is present and spreading to the respiratory system. One doctor reported that the lesions appear to mimic purpura fulminans that occur when inflammation from severe infection causes the body to make micro-clots in the tiny vessel in the toes and sometimes the fingers.
If COVID toes occur in these high-risk patients, the likelihood that they will ulcerate is high and will likely require the supervision of a wound care specialist as part of a multidisciplinary medical team to be sure the ulcerations do not become stubborn or chronic wounds. A patient who is high-risk with an ulcerated lesion can be a breeding ground for additional infection in the patient’s already vulnerable body.
It can be overwhelming to watch all the news and talk shows that give an inundation of statistics and information. Social media is full of theories and opinions. This can be too much for many.
The only thing you need to know is facts. If there are new symptoms, be sure you are aware of them so you can be watching for them in yourself and your loved ones. COVID-19 must be battled with facts rather than fiction for everyone to be on one page and fight this crisis as one.